Sastry - Book on clinical cases, Vol 1

From Mk Sastry 

Pages 786 

Clinical cases 180 vol 1 

Total volume 6 . 

Life is made from nature and its all powerful , just we need to create the pathway. The Road to recover. 

When it was my first interaction with Acupuncture, I thought  it was hoax but than when i went ahead with studies i saw , How medically efficient , it is. I loved it show much , that it became my only family. I decided never to marry. Because, I believed it was very beautiful.. when doors are closed there is still a way.  

All this years i got only challenging and critical cases , Nationally and Internationally. There recovery changed my life and a manuscripts was created.  

Many records  of critical and chronic cases are mentioned  here and how I recovered them. The procedure , my clinical reasons and how i recovered them ..

While writing this book , I just wish to mention , No one is Superior or Inferior , based on our education and degree or experience. We are all from Nature and return to same . In between whatever we can do let us do before we return to dust with love and affection 

I will be happiest person if i can give my entire life to this profession with patients in Hospital.

Whenever people shall call Medical  Acupuncture as hoax. This book will stand on there way and might clear some doubts of there mind.

Dermatome test technique

Begin by asking the client to perform a movement as per instructions and hold an isometric contraction against therapist resistance for a count of 5.

C5- Shoulder abduction Ask the patient to raise both their arms to the side of them simultaneously as strongly as then can while the examiner provides resistance to this movement. Compare the strength of each arm.

C6- Elbow flexion Test the strength of lower arm flexion by holding the patient's wrist from above and instructing them to "flex their hand up to their shoulder". Provide resistance at the wrist. Repeat and compare to the opposite arm. This tests the biceps muscle. Test the strength of wrist extension by asking the patient to extend their wrist while the examiner

resists the movement. This tests the forearm extensors. Repeat with the other arm.

C7- Elbow extension Ask the patient to extend their forearm against the examiner's resistance. Begin their extension from a fully flexed position because this part of the movement is most sensitive to a loss in strength. This tests the triceps. Note any asymmetry in the other arm.

C8 - finger Flexion Examine the patient's hands. Look for intrinsic hand, thenar and hypothenar muscle wasting. Test the patient's grip by having the patient hold the examiner's fingers in their fist tightly and instructing them not to let go while the examiner attempts to remove them. Normally the examiner cannot remove their fingers. This tests the forearm flexors and the intrinsic hand muscles. Compare the hands for strength asymmetry. Finger flexion is innervated by the C8 nerve root via the median nerve.

C8 - - Finger abduction & adduction Test the intrinsic hand muscles once again by having the patient abduct or "fan out" all of their fingers. Instruct the patient to not allow the examiner to compress them back in. Normally, one can resist the examiner from replacing the fingers. Finger abduction or "fanning" is innervated by the T1 nerve root via the ulnar nerve.

C8 & T1- Thumb Opposition To complete the motor examination of the upper extremities, test the strength of the thumb opposition by telling the patient to touch the tip of their thumb to the tip of their pinky finger. Apply resistance to the thumb with your index finger. Repeat with the other thumb and compare. Thumb opposition is innervated by the C8 and T1 nerve roots via the median nerve

L1 & L2 : Hip Flexion Proceeding to the lower extremities, first test the flexion of the hip by asking the patient to lie down and raise each leg separately while the examiner resists. Repeat and compare with the other leg. This tests the iliopsoas muscles.

L3 Test extension at the knee by placing one hand under the knee and the other on top of the lower leg to provide resistance. Ask the patient to "kick out" or extend the lower leg at the knee. Repeat and compare to the other leg. This tests the quadriceps muscle.

L3 Test extension at the knee by placing one hand under the knee and the other on top of the lower leg to provide resistance. Ask the patient to "kick out" or extend the lower leg at the knee. Repeat and compare to the other leg. This tests the quadriceps muscle.

L4 Ankle Dorsiflexion Test dorsiflexion of the ankle by holding the top of the ankle and have the patient pull their foot up towards their face as hard as possible. Repeat with the other foot. This tests the muscles in the anterior compartment of the lower leg.

L5 Great toe extension Ask the patient to move the large toe against the examiner's resistance "up towards the patient's face". This tests the extensor halucis longus muscle.

S1: Ankle plantar flexion and eversion/knee flexion Holding the bottom of the foot, ask the patient to press down as hard as possible. Or in standing rise up onto the ball of their foot. Repeat with the other foot and compare. This tests the gastrocnemius and soleus muscles in the posterior compartment of the lower leg.

S2 Test flexion at the knee by holding the knee from the side and applying resistance under the ankle and instructing the patient to pull the lower leg towards their buttock as hard as possible. Repeat with the other leg. This tests the hamstrings. [6]

Neuro-plasticity by Dr. MKS

From Mk Sastry 

Brain recovers by dry needle , small impulse make miracles. 

Its has been long, handy experience working with many brain and spine diseases which results to progressive paralysis or  total paralysis , including hangman fracture and spinal cord injury ,  And during my work with almost gone cases, and Autoimmune Brain and Spine cases , I realised  Brain has various pathways and most important is interneuron connection with peripheral pathways , and during my reaserch i enjoyed spending day night working in it. Corticospinal and Pyramidal pathway both can revive the life of a person in Progressive diseases. 

Hence i created all manuscript in collection of my book in three volumes with lot of medical case studies with my student specially Dr Rajesh jat . From Haryana. 

The basic understanding of my interest was that beauty , smile, touch , can stimulate the brain , why not stimulation from this inner pathways , in my work i mentioned that there are more than 108 pathways and sub 226 subpathway which the nature has already provided . Its very beginning says, BRAIN IS A FACTORY , GIVE INPUT YOU WILL GET THE OUT PUT. . And its growth will expand , this gave idea of dry needles based stimulation on principles of  neuroplasticity and we see instant changes in many chronic cases with Neuroplasticity. 

The output is provided through raw metrial you provide. The impulse.. 

It gives three volumes of various case studies and i genuinely wanted to give it for free to many people. 

I thought people will be very intrested to work on it. But i saw the different approach. When i individually spoke to them there mentality. 

Some said . Talking to me is highest frustration and Truma. Some said i m not prepared. Others said , i m not ready, Few said i dont have time.. 

This book is priceless , i wont like to sale , a million dollar book for money. Nor on request. 

Deserving will have it. 

I was happy , that a book which will be of great source of learning and would open multiple avenues of recovery , was finally descided not to be given to any. 

For I believe 

Physician should be highly self motivated and enthusiastic. Frustrated mind can never have neuroplasticity. 

It means correct and recorrect your self, and than you have neuroplasticity in the brain. 

There is no scope of frustration in medical science. 

Example i deleted my entire thesis which determined CSF generated in choroid plexus but i was wrong , after reading ...klarica .../0 i deleted my work. And restarted again under guidence of Prof Iype Cherian with zero. For i was very happy to do it. At verze of completion i deleted my work . 

Motivation is a force which is always correct.

Strongest muscle - A note from Dr. Srinesh Vemula

Dr. Srinesh Vemula

What is the strongest muscle in the human body?

Answer

There is no one answer for this question since there are different ways to measure strength. There is absolute strength (maximum force), dynamic strength (repeated motions), elastic strength (exert force quickly), and strength endurance (withstand fatigue).

Muscles. In De humani corporis fabrica, Andreas Vesalius, 1543. National Library of Medicine Digital Collections.

There are three types of muscles in the human body: cardiac, smooth and skeletal.

Cardiac muscle makes up the wall of the heart and is responsible for the forceful contraction of the heart. Smooth muscles make up the walls of the intestine, the uterus, blood vessels, and internal muscles of the eye. Skeletal muscles are attached to the bones and in some areas the skin (muscles in our face). Contraction of the skeletal muscles helps limbs and other body parts move.

Most sources state that there are over 650 named skeletal muscles in the human body, although some figures go up to as many as 840. The dissension comes from those that count the muscles within a complex muscle. For example the biceps brachii is a complex muscle that has two heads and two different origins however, they insert on the radial tuberosity. Do you count this as one muscle or two?

A volunteer … tests his muscle strength on the hand dynameter. G. V. Hecht, photographer. National Library of Medicine Digital Collections.

Although most individuals have the same general set of muscles, there is some variability from one person to another. Generally, smooth muscles are not included with this total since most of these muscles are at cellular level and number in the billions. In terms of a cardiac muscle, we only have one of those- the heart.

Muscles are given Latin names according to location, relative size, shape, action, origin/insertion, and/or number of origins. For example the flexor hallicis longus muscle is the long muscle that bends the big toe:

Flexor = A muscle that flexes a joint

Hallicis = great toe

Longus = Long

Gymnastics – Medical:  Patient Gymnasticon, or machine for exercising the joints and muscles of the human body.  National Library of Medicine Digital Collections

The following are muscles that have been deemed the strongest based on various definitions of strength (listed in alphabetical order):

External Muscles of the Eye

The muscles of the eye are constantly moving to readjust the positions of the eye. When the head is in motion, the external muscles are constantly adjusting the position of the eye to maintain a steady fixation point. However, the external muscles of the eye are subject to fatigue. In an hour of reading a book the eyes make nearly 10,000 coordinated movements.

Gluteus Maximus

The gluteus maximus is the largest muscle in the human body. It is large and powerful because it has the job of keeping the trunk of the body in an erect posture. It is the chief antigravity muscle that aids in walking up stairs.

Heart

The hardest working muscle is the heart. It pumps out 2 ounces (71 grams) of blood at every heartbeat. Daily the heart pumps at least 2,500 gallons (9,450 liters) of blood. The heart has the ability to beat over 3 billion times in a person’s life.

Masseter

The strongest muscle based on its weight is the masseter. With all muscles of the jaw working together it can close the teeth with a force as great as 55 pounds (25 kilograms) on the incisors or 200 pounds (90.7 kilograms) on the molars.

Muscles of the Uterus

The uterus sits in the lower pelvic region. Its muscles are deemed strong because they contract to push a baby through the birth canal. The pituitary gland secretes the hormone oxytocin, which stimulates the contractions.

Soleus

The muscle that can pull with the greatest force is the soleus. It is found below the gastrocnemius (calf muscle). The soleus is very important for walking, running, and dancing. It is considered a very powerful muscle along with calf muscles because it pulls against the force of gravity to keep the body upright.

Tongue

The tongue is a tough worker. It is made up of groups of muscles and like the heart it is always working. It helps in the mixing process of foods. It binds and contorts itself to form letters. The tongue contains linguinal tonsils that filter out germs. Even when a person sleeps, the tongue is constantly pushing saliva down the throat.

The muscles. In Atlas of human anatomy and physiology, Sir Wm. Turner and John Goodsir, Edinburgh, 1857. National Library of Medicine Digital Collections

Thanks on Birthday wishes by Dr. MKS

From Mk Sastry. 

Dear All 

My blood relatives, my family members and all my friends wellwishers and students . 

Indebted with gratitude for the wonderful wish you all have given me on 3rd of july , the day called as my birthday. 

Rather today i wish to say something. I belong to that profession where i saw people and there family members were suffering and were waiting for near and dear ones to die . I saw them suffering in extreme pain and so i descided , i shall never get married , nor shall have family nor kids, nor my house, I could only see there sufferings. And so i descided , i will never see outside world nor television . It has been almost 14 years or when i saw the last the last television program. Never went to any parties , nor celebrated any event. Because i believe people were suffering. When i went to world tour to many countries i saw people are badly suffering there and so it made me a teacher . Good or Bad i dont know. But than to upgrade them . 

If i wanted,  the knowledge i have i can sell it and make huge money and also from my international consultancy. But  than only rich will come to me , so i made everything free in online treatment , so that people don't suffer. Because of me. Everyday treating international patient for free makes me happy that every min of my life is used. Treating and teaching only left. Whatever time remains i give to research. 

Sometimes i feel why i did so but than i saw people suffering. And that may be so. 

Hospital , patient , hotel room , and schedule of my classes , with research that's all i have. 

I had very good friend but than he left me . A friend who loved me like his son , from Indonesia. He came has student but took care of me like his son.   After that  i never entered to friendship because i dont think i can deliver anything good to anyone. 

I only know people are suffering and i must help them. What others are thinking i don't know. 

I gave this life to the society and that's all i know. 

Service before self , may i die with the same. 

So i lived and thus i died. I did not want to see anything else. Because people are suffering. 

I assure till my death , i will continue to work for 365 days *22 hours  hours and never on leave. 

Mk sastry final  wish to  die in Operation theater room recovering the last patient with needle in his hand. So i lived and thus i died. 

The needle i loved the most. 

Thankyou so much . 

Mk sastry .

Motor neurons by Dr. MKS

Motor neurons are not merely the conduits of motor commands generated from higher levels of the hierarchy. They are themselves components of complex circuits that perform sophisticated information processing. Motor neurons have highly branched, elaborate dendritic trees, enabling them to integrate the inputs from large numbers of other neurons and to calculate proper outputs.

 

Two terms are used to describe the anatomical relationship between motor neurons and muscles: the motor neuron pool and the motor unit. 

1. Motor neurons are clustered in columnar, spinal nuclei called motor neuron pools (or motor nuclei). All of the motor neurons in a motor neuron pool innervate a single muscle, and all motor neurons that innervate a particular muscle are contained in the same motor neuron pool. Thus, there is a one-to-one relationship between a muscle and a motor neuron pool.
2. Each individual muscle fiber in a muscle is innervated by one, and only one, motor neuron (make sure you understand the difference between a muscle and a muscle fiber). A single motor neuron, however, can innervate many muscle fibers. The combination of an individual motor neuron and all of the muscle fibers that it innervates is called a motor unit. The number of fibers innervated by a motor unit is called its innervation ratio.

Common Abbreviations used by Doctors

Abbreviation	Description
Rx	Treatment
Hx	History
Dx	Diagnosis
q	Every
qd	Every day
qod	Every other day
qh	Every Hour
S	without
SS	On e half
C	With
SOS	If needed
AC	Before Meals
PC	After meals
BID	Twice a Day
TID	Thrice a Day
QID	Four times a day
OD	Once a Day
BT	Bed Time
hs	Bed Time
BBF	Before Breakfast
BD	Before Dinner
Tw	Twice a week
SQ	sub cutaneous
IM	Intramuscular . .
ID	Intradermal
IV	Intravenous
Q4H	(every 4 hours)
QOD	(every other day)
HS	(at bedtime)
PRN	(as needed)
PO or "per os" (by mouth)
AC (before meals)
PC	(after meals)
Mg	(milligrams)
Mcg/ug	(micrograms)
G or Gm	(grams)
1TSF ( Teaspoon)	5 ml
1 Tablespoonful	15ml
DDx	differential Diagnosis
Tx	Treatment
RTx	Radiotherapy
CTx	Chemotherapy
R/O	rule out
s.p	status post
PMH(x)	post medical history
Px	Prognosis
Ix	Indication
CIx	contraindication
Bx	biopsy
Cx	complication